The purpose of this study is to examine the association between cerebral small vessel disease (CSVD) and neurological outcomes following traumatic brain injury (TBI).

TBI is a leading cause of morbidity and mortality resulting in significant socioeconomic burden. The pathophysiology underlying post-TBI neurocognitive deficits remains poorly understood and reliable predictors of long-term impairment are lacking. Recent evidence has identified microvascular disruption as a potential determinant of post-traumatic outcomes. We hypothesize that the presence of pre-existing CSVD is associated with worse functional impairment following TBI.

This retrospective analysis is ongoing with final results to be presented at the AAN Annual Meeting. Patients who underwent neurologic evaluation for post-TBI deficits at Mayo Clinic Florida between 2006-2020 and had brain MRI were included. Presence and severity of pre-existing CSVD will be quantified using the validated 4-point Fazekas scale (range 0–3) on brain MRI. Patient outcomes following TBI will be assessed using the modified Rankin Scale (mRS) and Glasgow Outcome Scale (GOS) within 12 months of brain injury.

We identified 125 women and 112 men (mean age 50 years) who were evaluated for post-TBI deficits. 131 patients (55%) had a diagnosis of mild TBI and 106 patients (45%) had a diagnosis of moderate-severe TBI. Patients will be grouped by CSVD severity by Fazekas score and outcomes will be dichotomized into ‘good’ (mRS = 0-2 or GOS = 4-5) and ‘poor’ (mRS = 3-6 or GOS = 1-3) for the primary study outcomes. Categorical variables will be analyzed by chi-square or Fisher’s exact test as appropriate.

Results from this study have the potential to further inform understanding of the association between cerebrovascular disease and functional impairment following TBI to improve prognostic accuracy and clinical management.